First word – Editorial – Trends in Urology & Men’s Health December 2010

We are all getting fatter. Obesity is reaching epidemic proportions throughout the developed and developing world. Obesity is a significant risk factor for premature death from cardiovascular disease. Data from the World Health Organization show that 17.1 million people around the world died of heart disease or stroke in 2004, and that number is predicted to rise to 23 million by 2030. Diabetes, which is another obesity-related disease, is also rising alarmingly in prevalence. It is envisaged that the number of people worldwide suffering from diabetes will rise from the current 200 million to 366 million by 2030.

How, then, can we help men to help themselves (one of the key aims of this new journal) to overcome the problem of obesity? We have found that five simple rules (rather than recommendations, which can easily be ignored) help men to get themselves into a better PLACE:

Portion control: the quantities of food served and consumed are generally too large, resulting in more calories being taken in than are utilised.

Lose the booze: alcohol intake continues to rise and the middle classes have managed to convince themselves that wine drinking, especially red wine, is healthy. In fact, most alcoholic drinks are highly calorific, and beer drinking especially is associated with unsightly and unhealthy central obesity.

Avoid snacking: cutting out food in between meals is a good way of achieving calorie control. Most snacks are loaded with either calories or salt or both.

Cut the carbs: carbohydrates are not only a major energy source in their own right, but also produce insulin release, which drives the glucose into the cells; this in turn results in hunger within a few hours of eating. Sandwiches at lunchtime induce hunger by teatime and thereby encourage mid-afternoon grazing, increasing the risk of obesity.

Exercise every day: 21st-century life seems to conspire against taking regular exercise. A heavy work schedule, and using lifts and escalators rather than the stairs, and taxis and buses rather than walking, all reduce the amount of exercise taken during day-to-day activities. A regular exercise regimen has been shown to reduce weight and cardiovascular risk and reverse pre-diabetes. Most men enjoy taking exercise; it is usually a question of
getting organised to do so, against a backdrop of a demanding working and family life.

The trick is to encourage enduring lifestyle change, rather than a short-term diet followed by a return to bad old habits. In this respect, our mnemonic seems to help. We have to accept that we are all led into daily dietary temptation – one can’t buy a newspaper without walking a gauntlet of sugary snacks, and cheap alcohol is on sale at almost every petrol station. We have to resist.

As doctors with an interest in men’s health, it is our responsibility not only to help our patients get to a better PLACE, but also to lead by example and make a start by getting there ourselves!


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